5 Things Washington: Sen. Randi Becker, Gov. Martin O’Malley, Amazon and healthcare

We are in week three of the legislative session, day three of the federal government shutdown. But, day one of Amazon’s automated grocery shopping experience.

In a year, will we be talking about the positive (versus negative) disruption of government in 2018? Or of Amazon? It’s what we’re watching in Washington State health care for January.


1.  Legislative action in week 3 of session

The first policy cutoff in the short legislative session is Feb. 2nd. So, this is in practice the last week for interesting bills to get a public hearing. The field of legislation narrows considerably after the 2nd.

SB 6225 is being heard today. It would extend Medicaid-like benefits to “qualified aliens” between 19 and 26 years old. SB 6399 is a new bi-partisan bill that would require reimbursement for services provided by tele-medicine to be equal to services provided in person. Facility fees are specifically not allowed.  In the House, Rep. Wilcox has a bi-partisan bill to launch a task force and a pilot program to address suicide and behavioral health issues in the agriculture sector.

Notably, the inimitable Rep. Eileen Cody has passed 21 bills out the House committee she chairs, with 14 more scheduled for executive session this week. Senate Chair Sen. Annette Cleveland has moved two out of Senate Health, with zero bills currently scheduled for exec session this week.


2. Video: Senator Randi Becker

Senator Randi Becker is the Caucus Chair for the Senate Republicans, and a member of the Senate Health Care Committee. Before joining the legislature, Sen. Becker worked as the administrator of a surgical center.  Along the way, she helped develop an Obesity Surgical Practice in the Auburn area and worked for Good Samaritan Hospital, where she started several hospital-owned clinics. She joins us in this edition of “What They’re Watching” to talk about why providers should be involved in legislative process.

“I worked in the medical field for years, and what I found was that doctors want to be the doctors and take care of their patients. And they don’t have a lot of the extra time to get in and learn about all of the policies. So I would say to any of those providers out there that have the support kind of person, send them (to Olympia) so that they have the ability to be knowledgeable about what may be coming down the pike.”


3.  Podcast:  Former Governor Martin O’Malley

As governor of Maryland, Martin O’Malley led one of the most innovative reform efforts to have been implemented in any state. By moving hospitals to a fixed and predictable payment model, incentives for the organizations were redirected from quantity to a new focus on quality. O’Malley was a candidate for the Democratic nomination for President in 2016, and made health care an important part of his campaign.

In this podcast, we  have an extended conversation with O’Malley. We talk through some of the health care reforms he worked on in Maryland, and the current state of our national politics. Take a listen here and be sure to subscribe!


4. Government shutdown and HHS operations

About 50% of operations at HHS are shut down today, according to the agency’s planningdocuments. The “master plan” shows each division’s furlough count by FTE. Each administration is responsive to varying criteria, law, and funding sources to determine whether and how it operates. It’s not a “black and white” arrangement.

On a related matter that caught my eye, Oregon Senator Ron Wyden last week sent a letter to HHS General Counsel requesting a review of CMS director Seema Verma’s engagement on state waivers. She appears to have been personally involved in waivers with states for which she was previously a paid consultant. Wyden believes this is a violation of an ethics agreement Verma signed.


5.  Amazon makes key Seattle hire; shopping for health care acquisitions

Amazon has reportedly hired Marty Levine, MD, formerly of Group Health and Iora, “in its latest push into health care.”  Levine is a great hire, and a very smart actor in the space where primary care, technology and payment come together to support quality outcomes.

It’s another big step for Amazon that is, I’m told, actively exploring possible acquisitions into the health care space. These conversations include purchasing the largest names in US health care, particularly on the health plan side.

If we learn from their work in the grocery space, the Whole Foods deal seemed like a big move. Today’s news about automating in-person grocery shopping is perhaps even bigger news, particularly if you’re one of the 3.4m grocery store cashiers in the US.

If you’re one of the 1m physicians in the US, Amazon’s efforts to “push the boundaries of computer vision and machine learning” is not likely to end at groceries.